What to try before an office procedure

What to change in your daily routine

End a walk sooner if the joint aches more later that day. Divide yard work or housework into shorter periods with rests. Firm shoes may help when your foot, knee, or hip carries weight. A cane can steady you when the joint feels weak.

Stronger muscles can take some strain from a sore joint. Physical therapy can teach movement and strength work suited to you. Don't push through sharp pain or swelling that increases during activity. Resume slowly after a flare instead of rushing back.

What to discuss with your doctor

Tell your doctor which daily tasks have become harder. Ask whether a brace, cane, medicine, or physical therapy may help. Some medicines aren't safe with certain heart, kidney, or stomach problems. Your medicine list helps the doctor choose carefully.

The letters PRP mean platelet-rich plasma, made by drawing and spinning your blood to collect platelets, the small parts that help clotting. Some people in studies had less soreness and moved better for months, while others had little change. Ask to see results for the same joint and the same PRP preparation. Then ask how many people walked, climbed stairs, or slept better.

When to ask about joint preservation or surgery

Joint preservation means an operation that repairs one area while keeping your natural joint. It may fit damage in one spot, but it isn't right for everyone. Replacement surgery may fit when damage and daily limits are severe. A surgeon can explain both choices without making you schedule anything.

Ask about recovery, driving, sleep, and help you'll need at home. Compare those answers with the time and cost of office care. Surgery isn't a personal failure after years of soreness. Choose by the exam, the daily task you miss, and the recovery you can manage.

Sources

1. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

2. The OARSI non-surgical management guideline evaluated 60 interventions with GRADE methodology and built its recommendations around core treatments - structured exercise, weight management and self-management education - for every patient with knee osteoarthritis, regardless of what else is added.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

3. Global Burden of Disease data show osteoarthritis age-standardised prevalence rose 9.3 percent between 1990 and 2017 and years lived with disability rose 9.6 percent, with prevalence higher in women and rising with age.

   Safiri S, et al. — Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis, 2020. DOI: 10.1136/annrheumdis-2019-216515.

4. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.

5. MACI is FDA-licensed (STN BL 125603, Vericel Corporation) and is indicated for the repair of symptomatic, single or multiple FULL-THICKNESS cartilage defects of the knee with or without bone involvement in adults - a focal defect repair performed surgically, not a treatment for osteoarthritis and not an injection.

   US Food and Drug Administration — MACI (autologous cultured chondrocytes on porcine collagen membrane). , 2016.

6. FDA's list of licensed cellular and gene therapy products is the checkable public record of what has actually been approved; the orthopedic entry on it is MACI (autologous cultured chondrocytes on porcine collagen membrane), and the cord blood entries (HEMACORD, ALLOCORD, DUCORD and others) are hematopoietic products for blood disorders, not joint treatments.

   US Food and Drug Administration, Office of Therapeutic Products — Approved Cellular and Gene Therapy Products. , 2026.

7. On 18 December 2024 FDA approved RYONCIL (remestemcel-L-rknd), the first mesenchymal stromal cell therapy ever approved in the United States - for steroid-refractory acute graft-versus-host disease in pediatric patients 2 months and older, given as eight intravenous infusions. It is not an orthopedic product and does not make any joint injection approved.

   US Food and Drug Administration — FDA Approves First Mesenchymal Stromal Cell Therapy to Treat Steroid-refractory Acute Graft-versus-host Disease. , 2024.